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目的:探讨高血压病(EH)患者血管紧张素转换酶(ACE)基因多态性是否存在种族、民族和地区差别,观察不同ACE基因型EH患者输入生理盐水后的血压反应。方法:应用聚合酶链式反应(PCR)技术检测688例EH患者ACE基因多态性,同时观察110例住院患者静脉应用生理盐水的输液量,输液前、后的血压。结果:(1)福州患者ACE-II基因型构成比(35.3%)高于法国(14.8%)、低于日本(40.0%)和中国北方(39.7%)患者(P<0.005),但I等位基因分布频率随地区的接近差异逐渐缩小,到中国福州与河北地区差异已无统计学意义;(2)ACE-II基因型患者输入生理盐水5 d后收缩压升高明显高于ACE-ID型和ACE-DD型患者(P分别<0.001和<0.01),而且24%(26/110)的患者在每天输入600 ml以上的生理盐水5 d后,平均压比输液前升高超过5 mmHg,其中绝大部分为ACE-II型。结论:福州地区EH患者ACE基因多态性的检测结果在一定程度上反应了国人EH患者ACE基因多态性的分布情况。ACE-II基因型的测定可简单易行地为国人盐敏感性EH患者的诊断和治疗提供参考。
Objective: To investigate whether there is racial, ethnic and regional differences in angiotensin converting enzyme (ACE) gene polymorphism in hypertensive patients (EH) and to observe the blood pressure response after infusion of physiological saline in different ACE genotypes. Methods: Polymerase chain reaction (PCR) was used to detect ACE gene polymorphism in 688 patients with EH. At the same time, 110 intravenous infusion of saline and blood pressure before and after infusion were observed in 110 inpatients. Results: (1) The proportion of ACE-II genotype in Fuzhou was higher than that in France (14.8%), lower than that in Japan (40.0%) and northern China (39.7%) (P <0.005) There was no significant difference between Fuzhou and Hebei in China. (2) The systolic blood pressure of ACE-II genotype patients was significantly higher than that of ACE-ID (P <0.001 and <0.01, respectively), and in 24% (26/110) of patients receiving more than 600 ml saline daily for 5 days, the mean pressure increased more than 5 mm Hg , Most of them ACE-II type. Conclusion: The results of ACE gene polymorphism in patients with EH in Fuzhou area to a certain extent reflect the distribution of ACE gene polymorphism in Chinese EH patients. ACE-II genotyping can be simple and easy for people with salt-sensitive EH diagnosis and treatment of patients with reference.